The prognostic value of serum S100B in patients with cutaneous melanoma: A meta‐analysis

Abstract

S100B protein detected in the serum of patients with cutaneous melanoma has been long reported as a prognostic biomarker. However, no consensus exists on its implementation in the routine clinical setting. This study aimed to comprehensively and quantitatively summarize the evidence on the suitability of serum S100B to predict patients' survival. Twenty-two series enrolling 3393 patients with TNM stage I to IV cutaneous melanoma were reviewed. Standard meta-analysis methods were applied to evaluate the overall relationship between S100B serum levels and patients' survival (meta-risk). Serum S100B positivity was associated with significantly poorer survival (hazard ratio [HR] 5 2.23, 95% CI: 1.92-2.58, p < 0.0001). Between-study heterogeneity was significant, which appeared to be related mainly to dissemination bias and the inclusion of patients with stage IV disease. Considering stage I to III melanoma (n 5 1594), the meta-risk remained highly significant (HR 5 2.28, 95% CI: 1.8-2.89; p < 0.0001) and studies' estimates were homogeneous. Subgroup analysis of series reporting multivariate survival analysis supported S100B as a prognostic factor independent of the TNM staging system. Our findings suggest that serum S100B detection has a clinically valuable independent prognostic value in patients with melanoma, with particular regard to stage I-III disease. Further investigation focusing on this subset of patients is justified and warranted before S100B can be implemented in the routine clinical management of melanoma.

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

“…Unlike stage I-III, studies in stage IV melanoma patients displayed relevant heterogeneity. The meta-risk, however, was -independent of subgroup -always higher for S100B-positive patients [118], confirming a positive correlation between TNM stage and S100B-positivity. There is a significant rise in the percentage of S100B-positive patients when comparing various trials with patients at stage I-III (13.4 %), stage I-IV (28.3 %), and stage IV (41.8 %) alone (p < 0.0001).…”

“…Technical parameters, e.g. an appropriate cut-off value, could not be identified in meta-analysis [118]. Separate evaluation of S100B at stage III was not conducted in this meta-analysis, in-stead combined assessment of stage I-III and I-IV.…”

“…Concerning the prognostic value of serum S100B levels, a meta-analysis of 22 smaller studies with a total of 3 393 patients exists [118]. A majority of included studies show that S100B levels are significantly correlated with patient survival and constitute an independent prognostic factor in multivariate analysis.…”

“…Systematic search of the literature de-novo: [118,120,612,613,620] Strength of consensus: 92 % I. Satzger, U. Leiter Serum levels of this tumor marker are dependent on the patient's tumor load. Thus, increase in S100B levels over time may portend disease progression.…”

Optimal follow-up for melanoma

“…Successful treatment with lymph node dissection, chemotherapy or immuno therapy was associated with decreased S-100B concentrations, whereas increased concentrations were an expression of disease progression [112,116,117]. Recently it was reported by several studies that S-100B can be used as a prognostic marker for disease-free survival and overall survival directly after therapeutic lymph node dissection in stage III melanoma [118][119][120][121]. Data from our center were not only in concordance with the above described findings, but also revealed that S-100B can be used as a prognostic marker for disease-free survival when determined before dissection.…”